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Pancreaticobiliary fistula associated with pancreatolithiasis

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Abstract

We report here a case of pancreaticobiliary fistula associated with pancreatolithiasis. A 47-year-old female without a habit of alcohol drinking was admitted by her family physician after suffering from mild acute pancreatitis. Computed tomography revealed mild acute pancreatitis with pancreatolithiasis at the head of the pancreas. The pancreatolithiasis was exposed to the inner surface of the common bile duct and possibly compressed and narrowed the Wirsung and Santorini ducts, resulting in the pancreatitis attack. We used extracorporeal shock wave lithotripsy to treat the pancreatolithiasis. After complete elimination of stones by extracorporeal shock wave lithotripsy, endoscopic retrograde cholangiography showed an apparent pancreaticobiliary fistula between a branch of the Santorini duct and the lower portion of the common bile duct. There was no communication between the bile duct and the Wirsung duct or its branches; therefore, the diagnosis was not pancreaticobiliary maljunction. There have only been a few reports of pancreaticobiliary fistula without an association with pancreatic pseudocysts or intraductal papillary-mucinous pancreatic neoplasm, and there have only been few reports of pancreaticobiliary fistula with pancreatolithiasis.

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References

  1. Glass R, Newstedt J. Hemobilia: an unusual complication of chronic pancreatitis. Missouri Med. 1964;61:853–4.

    CAS  PubMed  Google Scholar 

  2. Dalton W, Lee H, Williams G, Hume DM. Pancreatic pseudocyst causing hemobilia and massive gastrointestinal hemorrhage. Am J Surg. 1970;120:106–7.

    Article  CAS  PubMed  Google Scholar 

  3. Sankaran S, Walt A. The natural and unnatural history of pancreatic pseudocysts. Br J Surg. 1975;62:37–44.

    Article  CAS  PubMed  Google Scholar 

  4. Grace R, Jordan P. Unresolved problems of pancreatic pseudocysts. Ann Surg. 1976;184:16–21.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Ro JO, Yoon BH. Pancreatic pseudocyst as a cause of gastrointestinal bleeding and hemobilia. A case report. Am J Gastroenterol. 1976;66:287–91.

    CAS  PubMed  Google Scholar 

  6. Ellenbogen KA, Cameron JL, Cocco AE, Gayler BW, Hutcheon DF. Fistulous communication of a pseudocyst with the common bile duct: demonstration by endoscopic retrograde cholangiopancreatography. Johns Hopkins Med J. 1981;149:110–1.

    CAS  PubMed  Google Scholar 

  7. Gadacz TR, Lillemoe K, Zinner M, Merrill W. Common bile duct complications of pancreatitis evaluation and treatment. Surgery. 1983;93:235–42.

    CAS  PubMed  Google Scholar 

  8. DeVanna T, Dunne MG, Haney PJ. Fistulous communication of pseudocyst to the common bile duct: a complication of pancreatitis. Pediatr Radiol. 1983;13:344–5.

    Article  CAS  PubMed  Google Scholar 

  9. Skellenger M, Pattersson D, Foley N, Jordan PH. Cholestasis due to compression of the common bile duct by pancreatic pseudocyst. Am J Surg. 1983;145:343–8.

    Article  CAS  PubMed  Google Scholar 

  10. Miller B, Traverso L, Freeny P. Intrapancreatic communication of bile and pancreatic ducts secondary to pancreatic necrosis. Arch Surg. 1988;123:1000–3.

    Article  CAS  PubMed  Google Scholar 

  11. Bresler L, Vidrequin A, Poussot D, Mangin P, Pinelli G, Boissel P, et al. Fistulous communication of a pancreatic pseudocyst with the common bile duct: demonstration by operative cholangiogram [letter]. Am J Gastroenterol. 1989;84:835–6.

    CAS  PubMed  Google Scholar 

  12. Verma GR, Kochhar R, Nagi B. Duodeno-pancreatico-choledochal rupture of pseudocyst [letter]. Gastrointest Endosc. 1991;37:588–9.

    Article  CAS  PubMed  Google Scholar 

  13. Dumas O, Jouffre C, Desportes R, Etaix J, Barthelemy C, Audigier J. Duodeno-pancreatico-choledochal rupture of pseudocyst [Letter]. Gastrointest Endosc. 1991;37:588–9.

    Article  Google Scholar 

  14. Hauptmann EM, Wojtowycz M, Reichelderfer M, McDermott JC, Crummy AB. Pancreatic pseudocyst with fistula to the common bile duct: radiological diagnosis and management. Gastrointest Radiol. 1992;17:151–3.

    Article  CAS  PubMed  Google Scholar 

  15. Saeed ZA, Ramirez FC, Hepps KS. Endoscopic stent placement for internal and external pancreatic fistulas. Gastroenterology. 1993;105:1213–7.

    Article  CAS  PubMed  Google Scholar 

  16. Schoefl R, Haefner M, Pongratz S, Pfeffel F, Stain C, Poetzi R, et al. Endoscopic treatment of fistulas and abscesses in pancreatitis: three case reports. Endoscopy. 1996;28:776–9.

    Article  CAS  PubMed  Google Scholar 

  17. Raimondo M, Ashby AM, York EA, Derfus GA, Farnell MB, Clain JE. Pancreatic pseudocyst with fistula to the common bile duct presenting with gastrointestinal bleeding. Dig Dis Sci. 1998;43:2622–6.

    Article  CAS  PubMed  Google Scholar 

  18. Carrere C, Heyries L, Barthet M, Bernard J-P, Grimaud J-C, Sahel J. Biliopancreatic fistulas complicating pancreatic pseudocysts: a report of three cases demonstrated by endoscopic retrograde cholangiopancreatography. Endoscopy. 2001;33:91–4.

    Article  CAS  PubMed  Google Scholar 

  19. Sakorafas G, Sarr M, Farnell M. Pancreaticobiliary fistula: an unusual complication of necrotising pancreatitis. Eur J Surg. 2001;167:151–3.

    Article  CAS  PubMed  Google Scholar 

  20. Apel D, Weickert U, Riemann J. Successful treatment of pancreatobiliary fistula by endoscopic stenting. Scand J Gastroenterol. 2004;39:395–7.

    Article  CAS  PubMed  Google Scholar 

  21. Rasmussen IC, Karlson BM, Löfberg AM. Biliary pancreatic portal fistula as a complication of chronic pancreatitis: a case report with review of the literature. Ups J Med Sci. 2006;111:329–38.

    Article  PubMed  Google Scholar 

  22. Rickes S, Mönkemüller K, Peitz U, Schinkel S, Kolfenbach S, Malfertheiner P, et al. Sonographic diagnosis and endoscopic therapy of a biliopancreatic fistula complicating a pancreatic pseudocyst. Scand J Gastroenterol. 2006;41:989–92.

    Article  PubMed  Google Scholar 

  23. Kurihara K, Nagai H, Kasahara K, Kanazawa K, Kanai N. Biliopancreatic fistula associated with intraductal papillary-mucinous pancreatic cancer: institutional experience and review of the literature. Hepatogastroenterology. 2000;47:1164–7.

    CAS  PubMed  Google Scholar 

  24. Okada K, Furuuchi T, Tamada T, Sasaki T, Suwa T, Shatari T, et al. Pancreatobiliary fistula associated with an intraductal papillary-mucinous pancreatic neoplasm manifesting as obstructive jaundice: report of a case. Surg Today. 2008;38:371–6.

    Article  PubMed  Google Scholar 

  25. Sano S, Nishimori I, Okamoto N, Kohsaki T, Onishi S, Morita M, et al. Biliopancreatic fistula caused by an intraductal papillary-mucinous tumor of the pancreas confirmed by biochemical analysis of mucin. Int J Gastrointest Cancer. 2003;34:101–6.

    Article  PubMed  Google Scholar 

  26. Tashiro S, Imaizumi T, Ohkawa H, Okada A, Katoh T, Kawaharada Y, et al. Committee for registration of the Japanese study group on pancreaticobiliary maljunction. Pancreaticobiliary maljunction: retrospective and nationwide survey in Japan. J Hepatobiliary Pancreat Surg. 2003;10:345–51.

    Article  PubMed  Google Scholar 

  27. Matsumoto Y, Fujii H, Itakura J, Matsuda M, Nobukawa B, Suda K. Recent advances in pancreaticobiliary maljunction. J Hepatobiliary Pancreat Surg. 2002;9:45–54.

    Article  PubMed  Google Scholar 

  28. Schneider HT, May A, Benninger J, Rabenstein T, Hahn EG, Katalinic A, et al. Piezoelectric shock wave lithotripsy of pancreatic duct stones. Am J Gastroenterol. 1994;89:2042–8.

    CAS  PubMed  Google Scholar 

  29. Karasawa Y, Kawa S, Aoki Y, Ochi Y, Unno H, Kiyosawa K, et al. Extracorporeal shock wave lithotripsy of pancreatic duct stones and patient factors related to stone disintegration. J Gastroenterol. 2002;37:369–75.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Gastroenterology, Shinshu University School of Medicine, 3-1-1 Matsumoto, Nagano, 390-8621, Japan

    Norikazu Arakura, Yayoi Ozaki, Masafumi Maruyama, Yoshimi Chou, Ryo Kodama, Mari Takayama, Hideaki Hamano & Eiji Tanaka

  2. Department of Internal Medicine, Japanese Red Cross Iiyama Hospital, Nagano, Japan

    Takashi Muraki

  3. Health, Safety and Environmental Management, Shinshu University, 3-1-1 Matsumoto, Nagano, 390-8621, Japan

    Shigeyuki Kawa

Authors
  1. Norikazu Arakura
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  2. Yayoi Ozaki
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  3. Takashi Muraki
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  4. Masafumi Maruyama
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  5. Yoshimi Chou
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  6. Ryo Kodama
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  7. Mari Takayama
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  8. Hideaki Hamano
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  9. Eiji Tanaka
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  10. Shigeyuki Kawa
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Correspondence to Norikazu Arakura.

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Arakura, N., Ozaki, Y., Muraki, T. et al. Pancreaticobiliary fistula associated with pancreatolithiasis. Clin J Gastroenterol 2, 226–231 (2009). https://doi.org/10.1007/s12328-009-0070-3

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  • DOI: https://doi.org/10.1007/s12328-009-0070-3

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